SB 863 was Worker's Compensation reform legislation, passed in August 2012 and which went into effect starting January 1, 2013. The remaining provisions will be going into place in the coming months. This bill affects Redding's injured workers by increasing disability payments, removes some compensable consequences, de-mystifying supplemental job displacement vouchers, and changing the way medical procedures are appealed.
While many advocates are excited about the changes brought into effect with SB 863, the feeling is not universal. See Julius Young's Article. There is some concern about how these changes will affect injured workers. Here is a quick run down for Redding's injured employee's of the benefits which have changed.
What is SB 863, and how has it affected injured worker's benefits?
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If you have been injured on the job, or if you have a medical condition or disability which you believe was caused or aggravated by your work activities, immediately file a report of injury with your employer. If you have any questions or concerns, contact us for a FREE consultation to discuss your rights, benefits, and options.
Increases in Permanent Disability:
PD benefits are designed to replace a portion of wages an injured worker will lose over time as a result of permanent disability from a work-related injury. Following changes in the work comp system in 2004, the amount of injured workers’ lost wages being replaced by PD benefits declined steadily after the passage of SB 899. The rating schedule has not had an increase since it was adopted in 2005.
SB 863 increase the minimum and maximum rates of PD for Redding worker's injured after January 1, 2013. In addition, there will be another increase to PD benefits for work-related injuries which occur after January 1, 2014. The new weekly minimum rate for permanent disability will increase from $195 to $240 and the maximum weekly rate for PD will have an increase from $405 to $435.
This bill would also create a $120 million fund to provide supplemental payments to injured workers who have suffered a serious or catastrophic injury and the injured worker's PD benefit payments are disproportionately low compared to their earnings losses.
Elimination of "Add-On" for Sleep, Sex, and Psych:
SB 863 eliminates PD for compensable consequences of sleep dysfunction, sexual dysfunction, and psychiatric disorder on work-related injuries on or after January 1, 2013. Employees who added on consequences for their injuries was becoming quite expensive for the insurance carriers. This claims, often referred to the 3S's (Sex, Sleep, Stress), were often raised, but mainly as settlement fodder, not for actual treatment.
While SB 863, eliminated raising these additional injuries for PD, injured workers are still able to receive medical treatment. Many carriers are now having applicant's C&R their 3S injuries and paying out future medical. There is no affect on injuries before January 1, 2013.
Redding Injured Worker's are receiving a Free Computer:
SB 863 made significant changes to the Supplemental Job Displacement Benefit, also referred to as a voucher. This change affects every voucher issued after January 1, 2013, regardless of date of injury. The voucher has now been limited to $6,000 no matter the level of PD.
Once an applicant is deemed permanent and stationary, an employer has 60 days to offer regular, modified, or alternative work. If the employer cannot accommodate the injured worker, they have 20 days to offer the voucher.
SB 863 expands what a voucher can be used for through LC 4658.7(e). The voucher may be used for the following:
• Professional certification fees & exam course fees
• Services of licensed placement agencies & resume preparation (up to 10%)
• Tools required by training or educational program
• Purchase of computer up to $1000
• $500 for miscellaneous expenses without documentation.
Yes, you read that correctly, up to $1000 for a new computer or computer equipment. Not to mention the additional $500 for other expenses.
Independent Medical Review:
Prior to SB 863, when Utilization Review (UR) denied your treatment, you had to object and go through a lengthy AME/ QME process. This process was slow, expensive, and inconclusive as a judge could override a determination. Under SB 863, when UR denies a treatment requested by a physician, the injured worker has 30 days to request an appeal.
The appeal is conducted by an Independent Medical Reviewer. This is a costly review for the insurance carrier. The hope is carrier's will approve inexpensive treatments which may be approved through IMR.
Finally, UR decisions shall now be effective for 12 months. So, once you have the IMR, the decision stands for 12 months, unless there has been a significant change in your medical condition.
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